Home Medical Equipment Sector Continues to Promote Tough Anti-Fraud Measures

Following the Philadelphia Health Care Fraud Prevention Summit on June 17, which is sponsored by the U.S. Department of Health and Human Services (HHS) and the U.S. Department of Justice, the American Association for Homecare released the following statement:

“The American Association for Homecare and its members have always had zero tolerance for fraud and will continue to work with federal officials to prevent fraud. In 2009, the American Association for Homecare proposed to Congress an aggressive 13-point Medicare Anti-Fraud Legislative Action Plan that includes tougher penalties for fraud, more site visits, and real-time claims audits to prevent fraud at the front-end of the process rather than relying on the ineffective pay-and-chase system. The majority of the Association’s recommendations have been adopted by Congress and the Centers for Medicare and Medicaid Services (CMS). However, we encourage Congress to adopt all of our proposals to ensure a comprehensive approach that directly shuts down avenues for Medicare fraud. A number of important new anti-fraud measures are now in place, which were long overdue. But Congress, CMS, and the HHS Office of Inspector General (OIG) should not impose unreasonable burdens on the existing, accredited home medical equipment providers. “Crooks, cheats, and con artists have no place in Medicare or healthcare in general,” said John Shirvinsky, executive director of the Pennsylvania Association of Medical Suppliers. “Unfortunately the CMS enforcement model has spent more time on punishing legitimate home medical equipment providers than eliminating the opportunity for bad actors to get into the Medicare system.” It’s important to point out that providers of home medical equipment must now be accredited by a deemed accrediting organization and they must also post a surety bond. These two requirements took effect in October 2009, and fraud associated with the home medical equipment sector has likely declined since then. We encourage federal officials to assess and report the rate of fraud since these requirements took effect. Spending in the home medical equipment sector represents less than 1.5 percent of total Medicare spending, and the HME proportion as well as the dollar amount in Medicare are falling. By any measure, any fraud or waste associated with home medical equipment sector can only represent a tiny fraction of total fraud, waste, or abuse in Medicare. The American Association for Homecare understands that lawmakers and regulators face the difficult challenge of reining in growing health care costs – and federal spending overall – which is why it is critical to note that home-based care is the most cost-effective setting for post-acute care. Congress must consider the aging U.S. population, the rising incidence of diabetes, COPD, and other chronic conditions, the high cost of treatment in hospitals and nursing facilities, and Americans’ clear preference for remaining safe and independent at home as they age. All of these factors argue for a stronger approach to providing homecare, not an erosion of the system.”

To see the 13-Point legislative plan, visit www.aahomecare.org/stopfraud.

HME Providers Educate Senate on Competitive Bidding Flaws

While bipartisan support continues to grow in the House for AAHomecare’s effort to stop the competitive bidding program, the Senate has failed to take action. Events for Senators held by members of the HME community have allowed providers the opportunity to discuss concerns with the suicide bidding program and the Senators to learn more about the challenges HME providers face, including an event for Sen. Scott Brown (R-Mass.) pictured with Tyler Wilson, president of AAHomecare. It is imperative that you contact both of your U.S. Senators to describe the problems with the Medicare bidding program for home medical equipment and services and request that they support legislation to stop or repeal the program.

To contact your member of Congress about the bidding program, visit www.capwiz.com/aahomecare.

The HILL Polls Voters on Medicare

Voters don’t want their existing or future Medicare benefits cut even if it would help reduce the national debt, according to a new poll conducted for The Hill.

Fifty-three percent of likely voters say they would not accept the idea of reduced benefits, while 33 percent said they would and 14 percent were unsure.

To read more about this poll, click here.

American Medical News reports delay of second round of Medicare equipment bidding

“The agency overseeing the Medicare program has delayed the second round of a durable medical equipment bidding program that was set to expand the initiative to 91 areas in the U.S.” The American Medical News explained that the announcement came during the April 5 Program Advisory and Oversight Committee meeting. The updated timeline shows bidding will “open soon after the start of 2012 and close in the spring of that year. CMS subsequently will announce the suppliers that have secured contracts for 2013.”

The article quotes Congressman Altmire, who co-introduced the bill with Rep. Thompson, "CMS' decision to delay round two of the competitive bidding program shows that even it acknowledges that this program is seriously flawed," said Rep. Jason Altmire (D, Pa.). "The truth is that no matter how CMS tries to tweak its competitive bidding program, it will continue to be a fundamentally bad deal for our nation's seniors and small businesses."

Altmire and Rep. Glenn Thompson (R, Pa.) said the delay is in response to a bill they have offered to repeal DME competitive bidding. They argue that the process squeezes out smaller suppliers and eliminates beneficiary choice. The bill, the Fairness in Medicare Bidding Act, had 75 co-sponsors at this article's deadline. It would offset the estimated savings from competitive bidding by directing the Obama administration to find roughly $20 billion in unspent funds elsewhere in the budget.

To read the full article, click here.

Medical equipment firms back bill to repeal bidding, Crain’s Detroit Business

A Crain’s Detroit Business article, published on April 10, outlined how home medical equipment (HME) companies in Michigan support H.R. 1041, a bill to repeal Medicare's competitive bidding program. The HME businesses feel this legislation “will prevent many of the companies from losing hundreds of thousands of dollars in revenue or going out of business.”

The article goes on to state that “’This program, which will put local home care providers out of business, will limit who Medicare beneficiaries can turn to for service,’ said Robert Binson, chairman of the Lansing-based Michigan Independent Providers Association, one of the groups that support the bill. The program forces patients into longer, more expensive hospital stays, which raises Medicare costs, said Binson, also president of Binson's Home Health Centers in Center Line.”

“While the regulation is intended as a Medicare cost-containment device, it could force 90 percent of the 500 Michigan home health supply vendors out of business, costing the state hundreds of jobs, several company executives have told Crain's.”

To read the full article, click here. (Free registration required)